Provider Demographics
NPI:1932907508
Name:SANDERS, DARIN KEITH JR
Entity type:Individual
Prefix:
First Name:DARIN
Middle Name:KEITH
Last Name:SANDERS
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 PARKWOOD CIR SE APT 2207
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-2253
Mailing Address - Country:US
Mailing Address - Phone:469-449-8080
Mailing Address - Fax:
Practice Address - Street 1:1500 PARKWOOD CIR SE APT 2207
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-2253
Practice Address - Country:US
Practice Address - Phone:469-449-8080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-07
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA187787246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant